HomeMy WebLinkAboutroof inspection affidavit • r
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Planning&Development Services
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"`°`:: Building&Code Regulation Division
2300 Virginia Avenue
Fort Pierce, FL 34952
772-462-2165 or 772-462-2 .72
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit#, 16,9
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licensed as a( Contracto * Engineer/Architect
(Please pri name&circle license type) "FS468 Building inspector
General,Build1ng,Residential ar Rao 'ng contractor or any Individual certified under 468 F.S-to make such on Inspection.
On or about 70 l , I did personally inspect the roof deck nailing
(Date)
work at:
(job site addre
Based upon that examination I have determined the installation was done according to the Hurricane
Mitigation Retrofit Manual (Based on 553.844 F.S.)
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sl n tore an eai License#
STATE OF FLOR1O_
COUNTY OF , t„
5wor i to and subscribed before me this / .--day of � /(�' 20
by 17 Who is personally known.[o n ie or who has produced
as identification.
Notary Public,State of Florida
Signature of Notary:
Commission Number: (seal)
En 01/19/2011DAVID VANDERFLIER
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MY COMMISSION#FF099950
EXPIRQS March 8,2010
(ao�)3sa-0753 Ftorldallol4 Service.com
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